Organization
TRUFFLES VEIN CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL DAVID FELDMAN M.D. (OWNER)
(678) 833-1444
Entity
Organization
Contact information
Practice address
874 LANIER AVE W, SUITE 120, FAYETTEVILLE, GA 30214-7662
(678) 833-1444
(678) 833-1409
Mailing address
874 LANIER AVE W STE 220, FAYETTEVILLE, GA 30214-7659
(678) 833-1444
(678) 833-1445
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000580423A
—
GA
01
—
24BCBRW
MEDICARE
GA
Enumeration date
09/21/2012
Last updated
07/23/2020
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